Comparing Two Pain Relief Methods After Midline Laparotomy Surgery Epidural Anesthesia Versus Bilateral Rectus Sheath Block

What this Trial Is About

Researchers are evaluating two different locoregional anesthesia techniques to manage postoperative pain and aid recovery after a midline laparotomy, a type of abdominal surgery. This randomized controlled trial compares the commonly used epidural analgesia with a newer method called bilateral rectus sheath block. The study aims to understand how these pain relief methods influence patients quality of recovery after surgery, measured by the Quality of Recovery-15 score. Participants are randomly assigned to one of two groups one receiving thoracic epidural analgesia, where a catheter is placed in the epidural space to deliver local anesthetic, and the other receiving bilateral rectus sheath block under ultrasound guidance, with anesthetic delivered via catheters on both sides of the abdomen. Both groups undergo the same type of abdominal surgery, and the treatments are part of a multimodal pain management approach during and after surgery. During the study, patients will be monitored for changes in recovery quality on postoperative days 1, 2, and 3, as well as the day before surgery. Assessments include pain control effectiveness, blood pressure effects, nausea, complications related to the analgesic technique, length of hospital stay, bowel function, morphine use, and patient satisfaction up to 30 days after surgery. Catheter placement success, mobility, and other postoperative events are also tracked to understand the impact of each anesthesia method on rehabilitation.

Influence of Analgesic Technique on Post Operative Rehabilitation After Median Laparotomy